Upper Limb

Question 1

The space directly underneath the GH Joint

Answer 1

Axilla

Question 2

Created by Skin and Axillary Fascia.
-Fascia attaches in front to the Pectoralis Major m. to form the Anterior Axillary Fold
-Fascia attaches posteriorly to the Latissimus Dorsi m. and Teres Major m. to form the Posterior Axillary fold
-Fascia envelopes these and is drawn tight, causing an infold of the fascia called the hollow of the armpit

Answer 2

Axillary Floor

Question 3

Triangular Shaped.
-Formed by the Clavicle (in front), scapula (behind), and 1st rib (medially)
-A portal to the axilla if you were to enter from a superior direction

Answer 3

Apex of the Axilla

Question 4

Anterior: Anterior Axillary Fold (Pectoralis Major m.)
Posterior: Posterior Axillary Fold (Latissismus Dorsi m. and Teres Major m.)
Medially: Upper portion of the Serratus Anterior m.

Answer 4

Borders of the Axilla

Question 5

-Fat (packing of space -bubble wrap)
-Fascia
-Axillary lymph nodes
-Axillary Artery
-Brachial Plexus

Answer 5

Contents of the Axilla

Question 6

Fascia that forms the floor of the Axilla and runs from the Pectoralis Major m. in front to the Teres Major m. and Latissimus Dorsi m. behind.
-Makes the hollow of the armpit that exists between the Anterior and Posterior Axillary Folds
-Stretching pulls it inward by being taut

Answer 6

Axillary Fascia

Question 7

Fascia wrapped around the Axillary Artery & Veins and Brachial Plexus to hold them together.
-Derived from scalene and pre-vertebral fascia
-Forms a “Fascial Tube”
-Axillary vein exits distally to run by itself

Answer 7

Axillary Sheath

Question 8

Deep to the Axillary Fascia. Covers the Axilla Anteriorly.
-Fascia that is stretched between the Subclavius m. and the Pectoralis Minor m.
-An opaque window that looks into the Axilla
-Ends in the Suspensory ligament of the Axilla (Gerdy’s).

Answer 8

Clavipectoral Fascia

Question 9

A ligament that runs from the Clavipectoral Fascia and attaches it into the Axillary Fascia.
-Wrinkles up, enhancing the “hollow” of the armpit. Accentuates the borders

Answer 9

Suspensory Ligament of the Axilla (Gerdy’s)

Question 10

Structures going from the axilla to the outside (and vice versa) have to pierce this.
- “Window” into the Axilla

Answer 10

Clavipectoral Fascia

Question 11

-Cephalic Vein: enters Axilla to drain into the Axillary Vein
-Thoracoacromial Artery (& Vein): exits Axilla to supply Pectoralis Major/Minor, Deltoid, and Subclavius muscles.
-Lateral Pectoral nerve: exits axilla to get to the Pectoralis Major m. to innervate it.

Answer 11

Structures passing through the Clavipectoral Fascia

Question 12

Longest vein in the upper limb. Starts dorsally on the hand, runs up forearm, all the way to upper arm, where it makes a U-turn in between Pectoralis Major m. and Deltoid m. (called the Delto-pectoral groove), pierces the Clavipectoral Fascia, and drains into the Axillary Vein

Answer 12

Cephalic Vein

Question 13

A branch off of the Axillary Artery that supplies the Pectoralis Major/Minor m., Deltoid m., and Subclavius m.

Answer 13

Thoracoacromial Artery

Question 14

Comes off of the Lateral Cord of the Brachial Plexus, passes over Pectoralis Minor m., pierces the Clavipectoral Fascia, and innervates Pectoralis Major m.

Answer 14

Lateral Pectoral Nerve

Question 15

Refers to the GH Joint (proximal humerus) down to the elbow

Answer 15

Brachium (Arm)

Question 16

Refers to the elbow joint to the wrist

Answer 16

Antebrachium (forearm)

Question 17

What are the components of the flexor compartment of the Arm?

Answer 17

-Biceps Brachii (long and short heads) m.
-Brachialis m.
-Coracobrachialis m.

Question 18

A large muscle with 2 heads: short (medial) and long (lateral)
-Elbow flexor
-Supinates the forearm
-Long head also flexes the GH joint
-Innervated by the Musculocutaneous Nerve

Answer 18

Biceps Brachii muscle

Question 19

Forms a tendon that approaches the GH Joint, burrows into the capsule, and attaches to the Supraglenoid Tubercle on the rim of the Glenoid Fossa
-Flexes the GH joint

Answer 19

Lateral (long) Head of the Biceps Brachii Muscle

Question 20

Attaches to the Coracoid Process of the Scapula

Answer 20

Short Head of the Biceps Brachii Muscle

Question 21

Best elbow flexor muscle
-Origin: Humerus
Crosses elbow joint anteriorly
-Inserts into Forearm
-Innervated by the Musculocutaneous Nerve

Answer 21

Brachialis Muscle

Question 22

Muscle that flexes and adducts the GH joint.
-Origin: Coracoid Process of the Scapula
-Insertion: Brachialis m.
-Innervated by the Musculocutaneous Nerve

Answer 22

Coracobrachialis Muscle

Question 23

Fascia that extends down from the shoulder and wraps around muscles of the flexor compartment to keep them intact (investing fascia)

Answer 23

Brachial Fascia

Question 24

Muscle that has 3 heads that all extend the elbow when they contract (straightens elbow out)
-Insert into the Olecranon Process
-Innervated by the Radial Nerve

Answer 24

Triceps Brachii Muscle

Question 25

-Elbow Extender -Also extends the GH Joint (brings it back down to starting position) -Origin: Infraglenoid Tubercle (bottom of glenoid fossa)

Answer 25

Long Head of the Triceps Brachii

Question 26

-Elbow Extender -Origin: posterior portion of the humerus

Answer 26

Lateral Head of the Triceps Brachii

Question 27

-Elbow Extender -Origin: posterior portion of the humerus -Have to cut and reflect Lateral Head to view

Answer 27

Short Head (medial head) of the Triceps Brachii

Question 28

Nerve that innervates the Flexor Compartment of the Arm. -Has to be anesthetized by itself- lies outside of the Axillary Sheath. -Inject into the Coracobrachialis Muscle -Innervates Biceps Brachii m., Brachialis m., and Coracobrachialis m.

Answer 28

Musculocutaneous Nerve

Question 29

Nerve that innervates the Extensor compartment of the arm -Triceps Brachii muscle

Answer 29

Radial Nerve

Question 30

An interruption of muscle between the Biceps Brachii m. and the Triceps Brachii muscle. -Filled in with fibrous, fatty tissue -Can feel an indent between muscles. -Contains several structures

Answer 30

Medial Intermuscular Septum

Question 31

An interruption between the Brachialis m. and the Triceps Brachii m. -Very small, not really a gap

Answer 31

Lateral Intermuscular Septum

Question 32

List the structures contained in the Medial Intermuscular Septum (7)

Answer 32

-Ulnar Nerve -Median Nerve -Brachial Artery -Lateral/Medial brachial Veins (on either side of Brachial Artery) -Medial Antebrachial Cutaneous Nerve (sensory to medial forearm) -Basilic Vein (largest vein in upper limb)

Question 33

What structure runs with the Median Nerve?

Answer 33

Brachial Artery

Question 34

What structure runs with the Basilic Vein?

Answer 34

Medial Antebrachial Cutaneous Nerve

Question 35

In the proximal portion of the arm, brachial artery is _____ and the median nerve is ______.

Answer 35

Medial; lateral

Question 36

As they move distally, the brachial artery and median nerve cross, and the brachial artery is now ______ and the median nerve is now ______.

Answer 36

Lateral; Medial

Question 37

This nerve splits off from the others to curve around the posterior elbow.

Answer 37

Ulnar Nerve

Question 38

Nerve that supplies sensory and motor function to the muscles in the anterior compartment of the forearm, and the muscles on the thumb side of your hand.

Answer 38

Median Nerve

Question 39

How do you anesthetize the Musculocutaneous Nerve?

Answer 39

Inject the Coracobrachialis Muscle.

Question 40

Occurs when the Musculocutaneous nerve runs out of branches and continues as a sensory branch that runs down the forearm. -Provides sensory to the lateral aspect of the forearm

Answer 40

Lateral Antebrachial Cutaneous Nerve

Question 41

Anesthesia to the Musculocutaneous Nerve should cause what?

Answer 41

Inability to flex the elbow, and loss of sensation to the lateral forearm.

Question 42

Nerve that comes off of the brachial plexus and runs posteriorly along the humerus. -Innervates the Triceps Brachii m. -Has a Posterior Cutaneous branch that provides sensation to the posterior arm (skin covering Triceps Brachii m).

Answer 42

Radial Nerve

Question 43

Nerve that supplies sensation to the posterior arm (skin covering Triceps Brachii m.)

Answer 43

Posterior Cutaneous branch of the Radial Nerve

Question 44

Branch off of the medial cord of the Brachial Plexus that supplies sensation to the medial aspect of the arm.

Answer 44

Medial Brachial Cutaneous Nerve

Question 45

Branch off of the medial cord of the Brachial Plexus that supplies sensation to the medial aspect of the forearm.

Answer 45

Medial Antebrachial Cutaneous Nerve

Question 46

Nerve that supplies sensation to the arm just distal to the axilla -A small area -Anastomosis with the Median Brachial Cutaneous Nerve -Emerges from the 2nd ICS, joins up with the Medial Brachial Cutaneous Nerve to form a nerve complex distal to the axilla -Sensory ONLY -Has to be blocked separately - does not arise from the Brachial Plexus

Answer 46

Intercostobrachial Cutaneous Nerve (T2)